What Is The Shift You Will Never Forget?

Nurses General Nursing

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Hello,

I'm not a nurse yet, although I have been a Mental Health Tech and a PCT. I love reading your nursing stories on here.

I would love to hear about the moments (good or bad) in your career that changed you or that you will always remember. Tell me about that one patient that got to you or that made your day.

Have fun and discuss!

PS....no it was not fear of catching HIV that stopped me....more of this is awkward I don't know this man type of thing.

Specializes in Pedi.

The shift I will never, ever forget happened one Thursday night into Friday... Friday the thirteenth. I was caring for one of my primary patients- an infant with hydrocephalus whose case easily would have gone to court had her parents not been teenagers without a clue. Initially, she presented from another hospital with a shunt infection. For reasons unknown to any of us nurses, our team was dead set on not putting her shunt back in. Infant had proven herself time and time again to be shunt dependent but the surgical team (led by the Fellow) felt that they could leave her with no drainage method and she'd be ok. Originally, she'd had external drains because of her infection. She failed every clamp trial they'd done but still they pulled her drain. The first time they did this, she was emergently in the OR within 12 hours having it replaced and had bled from the pressure. Because the blood blocked the communication between her ventricles, she ended up with two external drains. They eventually weaned her down to one. I had taken care of her the night before and she was supposed to be in the OR that Thursday morning to have her shunt replaced. On a whim, they decided to again try pulling her drain instead of her going to the OR to get her shunt. I was royally mad when I came in that Thursday night and heard what happened and knew immediately "we'll be in the OR emergently by the morning." By midnight, her respiratory rate was in the teens (she was 4 months old), she wouldn't wake to feed, her fontanelle was bulging and her pupils were sluggish. I will never forgot wheeling her crib down to a stat CT- she didn't flinch as we banged around the corner or ran the crib over bumps. After the results of the CT came back, it was clear she needed the OR and needed it now. The Resident made her NPO, ordered pre-op labs and told us she was going to the OR. I remember that I didn't hear from the OR so I called them to see what was going on. Their response? "We haven't heard from the Surgeon and our team is currently in a case. We would have to call in our on-call team and the Attending needs to call us." Turns out the Attending decided this could wait until normal business hours and soon the Chief Resident appeared and said "we're going to tap the baby's fontanelle." Several failed attempts before he finally withdrew something like 8 cc of bloody CSF from her. She remained lethargic with sluggish pupils and low O2 sats the whole night. The last thing I did that morning was run her to the OR at 6:30. I remember my boss coming in the next morning, hearing the story in report and saying "Kel, if this was your baby, what would you think/what would you do?" And I remember saying "If this was my baby, I would have had a lawyer a month ago." My boss agreed and said her next call would be to the press if it was her child. So many things were done wrong by this baby, so many things that I'm convinced wouldn't have happened if her parents hadn't been teenagers or had known how to advocate for her. She was back for urgent/emergent procedures at least once a month for the next several months. I have long since lost track of how many times I personally took her emergently to the OR.

It was when I finally got home that morning, around 9am, that I realized "it's Friday the thirteenth."

NOC nurse= night nurse

Specializes in Emergency.

My worst shift ever. Worked a 12 bed in patient oncology unit. It was me + a newish RN, who had been off orientation probably 3 months. Plus one CNA. We had 11 patients. There were multiple total cares and at least two medical patients who were actively withdrawing.

At about 2100, we get buzzed for a pneumonia patient - takes up our last bed. About 90 minutes later, I get a call from the house supervisor and I'm told that one of our regulars is in the ED and needs a bed. So transfer off one of the etoh patients and get this new guy settled in.

At some point during the night (can't quite remember the timeline - but I want to say it was between 2100 and midnight), a patient of mine who had nasopharyngeal cancer with a recent CEA (so her INR was up about 4.0) started bleeding out. Blood everywhere. I thought she was going to die on me right there. All three of us were in the room for half an hour dealing with this. 10-11 other patients were totally on their own. This woman was in our "neutropenic area", so her door was closed, while being in a seprate area, behind another set of closed doors. Stat transfusion of at least 3 units. And then when I left that morning, she was to get 3 more units of packed cells.

I didn't start my charting until 0500. No one took lunches & we ate oreos all night, whenever we could find a few seconds. I called and asked for more help, but there was none available.

Worst shift ever - we had 3 RN's and 1 aide for 15 patients on a medical oncology unit. Three were acute leuk patients, most patients on bed alarms and unable to do anything without help, a couple receiving chemo. One of our nurses had to leave at 2300 because she was vomiting and the hospital had no other staff to send us, which means no one could leave the floor for breaks/lunches/anything per hospital policy. We were extremely busy all night and then one of our acute leuk patients who was receiving chemo became unresponsive while the aide was doing his vital signs. We coded him, and in the process, his wife came screaming down the hallway. She screamed and sobbed loudly all through the code, as it was the first night in 14+ she had left his bedside to get some sleep at a hotel. The code ran forever but eventually had to be called. The ICU staff responding to the code was horribly rude, which added to everyone's stress. Of course, after that, the hospital suddenly had a couple extra aides that could help us "catch up." I think all three of us working that night were traumatized for quite some time afterward.

Specializes in family practice and school nursing.

thank you that's what i thought but wasn't sure.

Specializes in family practice and school nursing.
NOC nurse= night nurse
thank you. that's what I thought but I wasn't sure
Specializes in ICU, telemetry, LTAC.

There have been quite a few that were memorable. My first DIC patient I wound up sharing with another nurse, we did hour on, hour off for him- the hour out of the room we would snack, pee, chart and watch telemetry a bit. The hour in it was drips, give all the blood products, etc. I actually enjoyed that shift because we made a good team and we made progress with the patient, and never before or since have I been 2 nurse to one patient, no matter how sick they were.

Then there was the night the 15 year old crackhead tried to kill us all (if you believe what he was screaming) and the floor nurses thought I was doing chest compressions when they answered the code button. We just needed warm bodies before the police could get there, and that was not cpr, it was me trying to hold a dude down. It was one of three nights in my whole life that I had a cigarette when it was done. Supervisor was not helping with other issues and the doc wouldn't sign off on this healthy psycho so he could go to jail; I just called the hospital DON at home, at 6 on a sunday morning, and said oh my god please help me. Help happened. My ICU boss was on vacation far away or she would have been there in a hot minute.

Then there was the night on telemetry that everything went wrong. Let's see, the whole floor was full of about 100 plus visitors due to a traumatic, messy death in ICU, oh yes and in the middle of that right before our shift, a non-related lady coded in their waiting room so the tele nurses had to do that code, because she fell out due to the news her husband had died in ICU right along with the other lady. Ok. Before, during and after report every minute someone stopped us to say "how or where is XXXXX?" which was the very traumatic death in ICU. Holy cow. Then one of mine went psycho, thought I was his dog, took two IV's out and kept trying to PET me and take me for a walk. No. We had to call in a nurse just to be his nurse and tie him up good. Blah. A belly doc who had been in ICU walks into one of my pt's rooms with his toupee on sideways and blood all over him, says "ok we ready for surgery tomorrow? great!" and scared the bejeesus out of her. Not to mention all these shenanigans were LOUD. A mean, old, crabby CHF'er was found screaming in her room for folks to be quiet and find her daughter. The supervisor somehow collapsed in a laughing heap, tears running down his face outside her room, so much for help! I got her meds like, around midnight along with foolishly promising her that we would indeed quiet down. As soon as the words left my mouth I hear more screaming down the hall, come out of the room and the fire doors are shut. Hm?? I went and opened one and was yelled at "don't do that the bats will get back in!!" What the heck. The hospital does have a bat problem from time to time, and one got loose and was chasing the nurses up the hall from one end of our floor to the other. Somewhere on the other unit a heart patient was very upset that the nurse flung his door open to run into his room in the middle of the night all out of breath and wide-eyed, then refused to explain and walked back out a minute later. Hm. We all joked that if a baboon came charging up the hall next, it would not be a surprise.

That one's probably the best story. I can wait a long while to have a night like that again.

Specializes in Cardiopulmonary Stepdown/Cath Lab, ICU.

I would have to say mine occurred about 4 months off orientation. I get on my shift at 7pm to tele alarms going off during report, the patient I am about to get report on have a BP of 70s/50s. Run in there as pt. is still on a NTG drip from cath lab because blood pressures were too high. Okay so we stop that and bolus the pt., pressures bounce back...good. Finish getting report on my 3 other patients and the alarm starts going off for this patient again, pressure back into the 70s. Okay, let's investigate. Go in check groin site, looks/feels perfect, bolus again, page the doc. Pressure starts to drop again while waiting for Doc to call back, and now pt. is having nausea, back pain and trying to crawl out of bed. I am now officially concerned as the drips been off for 15-20 mintues. Call medical response just as doc calls me back, have to beg him for a CT as he thinks we're doing everything right and it's still the meds, "did I mention the back pain?"

Anyway patient goes to CT with ICU/medical response nurse, so I can attend to my other patients for 5 minutes. Comes back feeling slightly better but pressure still low, ICU nurse preparing for tx to unit just as CT calls me. Pt. has huge retro-peritoneal bleed from cardiac catheterization that is surrounding a kidney.

That was my Welcome to Nursing moment.

Pt. pulled through okay after a few days in the unit. Had the same pt. ~3 weeks later because one of her stents re-occluded. Went much better that time though.

The kick was my nurse educator came to me a week after the incident to tell me " you handled the situation very well, but next time chart in the proper section".... Really? I wrote a long a** note in the events tab along with all convos to doc and vital signs lol

Specializes in Medsurg/ICU, Mental Health, Home Health.

Well, there was the one that involved a gentleman actively DTing who kicked me in the head. But that was short lived because I was sent home due to my concussion.

Then there was the night I came on to two of my patients being RRT'd. One we moved to stepdown, then the other was made comfort care. I started her Morphine drip and about four hours later sent her to the morgue. Plus I had two admissions and a total jerk who wouldn't stop ringing his bell.

I think the dingdingding we have a winner, though is the night I came on to one of my patients being RRT'd. She was that every comorbidity in the book patient with a family who just wanted everything done. Anyway, the RRT team decided on no interventions as her pressure came up on its own.

Well, about two hours later, one of our techs had a grand mal seizure (no prior history) in that patient's room! I ran in and she was blue with blood shooting out of her mouth. She ended up being admitted. My charge asked me if I wanted to go home since I was shaken up. I declined.

That unfortunate patient, though, dropped her pressure for me. I bolused her but her pressure dropped even more so I called the RRT. It was basically the Keystone Kops running that one. They couldn't get central access in her so instead of moving her to the ICU waited around until a central line magically grew. (They wanted those pressors started before transport, even though she was stable at that time aside from her low pressure). They waited. And waited. And so she coded. We were all in the room doing our thing, I had broken all of her ribs even though there was no backboard under her. We were all getting kinda tired then we realized we forgot to call the freaking code. But we did and of course a surgical resident walks in, parts us like Moses with the Red Sea, starts a subclavian and walks back out nice as you please. And the code chief started to pass out because the room was hot and cramped and covered in blood and smelling like C-Diff. We got her back and I did the transport myself with the RRT nurse because I wasn't waiting around anymore. I ended up returning to the floor after 6 AM.

I went to give report when one of the electronic med carts starting sparking and we had to call a fire code.

So happy to get home THAT day!

Specializes in Neuro ICU and Med Surg.

Another shift I will never forget. I was right off orientation and I mean less than one month. On the night of 9/11 we had 3 RN's scheduled. I was the only one that was there so by default I became charge. Both RN's assigned with me that night were pregnant. One called in sick the other lived in Canada( I work in the metro Detroit area and we have quite a few Canadian nurses) and couldn't get across the border because it was shut down. It was just me and 2 float nurses. Thankfully they were helpful and we all worked together.

The first time that I was with someone as they passed away (in nursing school) I still remember her face and her family...and watching her husband by her side the entire time....with tears in his eyes...telling her it was ok, she could let go. She was 47 and passed away from lung cancer....the saddest thing I have ever experienced. She had a pretty labored death after she was extubated, which made the whole experience harder. I had trouble sleeping a couple days after that...my first experience with somone passing away before my eyes...it was pretty intense.

There are many great moments...and although it would take forever to list them all...they all involve seeing my patients smiling faces upon their discharge after they have had an extensive stay. After all, that is what our goal is...getting people better so they can go back home.

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